00:00:18.962 --> 00:00:21.795
(classical music)

00:00:55.496 --> 00:00:57.801
- [Narrator] The 10 largest
pharmaceutical companies

00:00:57.801 --> 00:01:00.955
form the so-called Big Pharma,

00:01:00.955 --> 00:01:04.872
which controls the world
pharmaceutical market.

00:01:06.487 --> 00:01:09.867
(classical music)

00:01:09.867 --> 00:01:13.965
In 2004, global spending
on prescription drugs

00:01:13.965 --> 00:01:16.048
amounted to $500 billion.

00:01:18.046 --> 00:01:21.508
In 2002, Big Pharma's
overall profit

00:01:21.508 --> 00:01:23.675
amounted to $35.9 billion.

00:01:26.631 --> 00:01:28.596
The profit made by Big Pharma

00:01:28.596 --> 00:01:30.778
exceeds the combined
total profits

00:01:30.778 --> 00:01:34.945
of the other 490 multinationals
on the Fortune 500 list.

00:01:36.627 --> 00:01:40.794
In 2004 Big Pharma registered
a total pretax profit

00:01:42.029 --> 00:01:43.362
of $205 billion,

00:01:45.394 --> 00:01:49.561
nearly as much as the gross
national product of Denmark.

00:01:51.396 --> 00:01:53.540
Here is a list of the 10
most widely-sold medicines

00:01:53.540 --> 00:01:56.217
in the world according
to the most up-to-data

00:01:56.217 --> 00:01:58.511
available for 2004.

00:01:58.511 --> 00:01:59.954
The most widely-sold medicine

00:01:59.954 --> 00:02:01.474
is the cholesterol-reducing
Lipitor,

00:02:01.474 --> 00:02:03.063
produced by Pfizer.

00:02:03.063 --> 00:02:07.204
It made $10.3 billion over
the course of just one year.

00:02:07.204 --> 00:02:09.081
Next comes another
cholesterol-reducing drug,

00:02:09.081 --> 00:02:11.756
Zocor, produced by Merck.

00:02:11.756 --> 00:02:15.167
It made $6.1 billion
in one year.

00:02:15.167 --> 00:02:18.166
The third most widely-sold
medicine is Zyprexa,

00:02:18.166 --> 00:02:20.554
an antidepressant
produced by Eli Lilly.

00:02:20.554 --> 00:02:23.137
It made $4.8 billion in a year.

00:02:25.128 --> 00:02:26.834
Among the remaining seven
most widely-sold

00:02:26.834 --> 00:02:27.864
medicines in the world,

00:02:27.864 --> 00:02:29.332
there are two istreatalsis,

00:02:29.332 --> 00:02:30.768
one for high blood pressure,

00:02:30.768 --> 00:02:31.783
one antidepressant,

00:02:31.783 --> 00:02:33.329
one for heart problems,

00:02:33.329 --> 00:02:35.572
one for asthma and
one for anemia.

00:02:35.572 --> 00:02:39.988
With a total annual turnover
of around $48 billion.

00:02:39.988 --> 00:02:41.826
All of these drugs was
sold in rich countries

00:02:41.826 --> 00:02:43.456
such as the United States,

00:02:43.456 --> 00:02:46.456
the European Union and Japan.

00:02:50.897 --> 00:02:53.730
(classical music)

00:03:09.141 --> 00:03:12.044
Geneva is the financial
heart of Europe.

00:03:12.044 --> 00:03:14.576
It is here that we must
start our investigation

00:03:14.576 --> 00:03:17.238
in order to understand the
political and economic problems

00:03:17.238 --> 00:03:20.744
of access to
pharmaceutical drugs.

00:03:20.744 --> 00:03:22.250
All the international
organizations

00:03:22.250 --> 00:03:23.818
which deal with pharmaceuticals

00:03:23.818 --> 00:03:25.985
have their base in Geneva.

00:03:28.368 --> 00:03:31.618
The World Health
Organization, WHO,

00:03:31.618 --> 00:03:35.427
the World Intellectual
Property Organization, WIPO,

00:03:35.427 --> 00:03:37.383
Medecins Sans Frontieres

00:03:37.383 --> 00:03:41.383
and, naturally, the World
Trade Organization, WTO.

00:03:43.324 --> 00:03:45.317
- And the WTO today,

00:03:45.317 --> 00:03:47.884
which covers many,
many different areas

00:03:47.884 --> 00:03:49.579
of international trade,

00:03:49.579 --> 00:03:51.340
trade in goods,

00:03:51.340 --> 00:03:52.840
trade in services.

00:03:53.824 --> 00:03:56.491
It covers a wide range of issues

00:03:58.112 --> 00:04:00.779
from tariffs and duties on goods

00:04:02.036 --> 00:04:04.786
to subsidies to
non-tariff rules.

00:04:05.761 --> 00:04:09.054
- [Narrator] The WTO
has 150 member states.

00:04:09.054 --> 00:04:11.703
Almost the entire planet.

00:04:11.703 --> 00:04:15.099
The world trade system is
governed by WTO agreements.

00:04:15.099 --> 00:04:18.492
- We started to look
into the new rules

00:04:18.492 --> 00:04:20.865
on pharmaceutical patenting

00:04:20.865 --> 00:04:23.132
that came out of the
World Trade Organization,

00:04:23.132 --> 00:04:25.362
which are called the
Trade-Related Aspects

00:04:25.362 --> 00:04:27.080
of Intellectual Property Rights,

00:04:27.080 --> 00:04:28.917
the TRIPS agreement

00:04:28.917 --> 00:04:31.804
because we saw that medicines
that were under patent

00:04:31.804 --> 00:04:33.914
were so much more expensive
than medicines

00:04:33.914 --> 00:04:35.626
that were not patented.

00:04:35.626 --> 00:04:38.459
(classical music)

00:04:51.434 --> 00:04:53.160
- [Narrator]
The International Federation

00:04:53.160 --> 00:04:56.687
of Pharmaceutical Manufacturers
& Associations, IFPMA,

00:04:56.687 --> 00:04:58.604
has its base in Geneva.

00:04:59.497 --> 00:05:02.025
- We have 26 member companies

00:05:02.025 --> 00:05:05.323
and we have 55
national associations,

00:05:05.323 --> 00:05:09.236
which are in 55 countries
around the world

00:05:09.236 --> 00:05:11.634
and the issues that we work on

00:05:11.634 --> 00:05:14.542
are basically regulatory issues

00:05:14.542 --> 00:05:16.443
because the
pharmaceutical industry

00:05:16.443 --> 00:05:19.339
is the most regulated
manufacturing

00:05:19.351 --> 00:05:21.290
industry that there is.

00:05:21.290 --> 00:05:22.598
Everything is regulated,

00:05:22.598 --> 00:05:24.999
from the clinical trials
to the patents

00:05:24.999 --> 00:05:27.578
to the pricing in many countries

00:05:27.578 --> 00:05:31.078
and so we work on
these regulatory issues.

00:05:32.684 --> 00:05:34.684
(speaking in Italian)

00:05:56.910 --> 00:05:58.939
- [Narrator] Here are the
five infectious diseases

00:05:58.939 --> 00:06:00.649
that kill the most people
every year,

00:06:00.649 --> 00:06:02.566
according to 2004 data.

00:06:03.491 --> 00:06:05.695
Various forms of
pulmonary disease,

00:06:05.695 --> 00:06:07.329
four million deaths.

00:06:07.329 --> 00:06:09.926
AIDS, 2.8 million deaths.

00:06:09.926 --> 00:06:12.426
Diarrhea, 1.8 million deaths.

00:06:12.426 --> 00:06:15.071
Tuberculosis, 1.6
million deaths.

00:06:15.071 --> 00:06:17.973
Malaria, 1.6 million deaths.

00:06:17.973 --> 00:06:19.315
The list goes on,

00:06:19.315 --> 00:06:22.775
accounting for 15 million
deaths a year.

00:06:22.775 --> 00:06:26.397
85% of the affected live
in the southern hemisphere,

00:06:26.397 --> 00:06:30.466
yet they account for only 11%
of world spending on health.

00:06:30.466 --> 00:06:31.521
In rich countries,

00:06:31.521 --> 00:06:35.555
15% of the world sick
spend the remaining 89%.

00:06:35.555 --> 00:06:39.475
- One, the medicines that
are desperately needed,

00:06:39.475 --> 00:06:42.539
diagnostic tools that
are desperately needed

00:06:42.539 --> 00:06:46.345
to diagnose people properly
or diagnose children properly,

00:06:46.345 --> 00:06:47.620
are not available.

00:06:47.620 --> 00:06:49.301
They are not being developed.

00:06:49.301 --> 00:06:53.302
Second, medicines that
we knew were available,

00:06:53.302 --> 00:06:54.335
for example,

00:06:54.335 --> 00:06:55.571
AIDS medicines,

00:06:55.571 --> 00:06:57.257
were not available in
developing countries

00:06:57.257 --> 00:06:59.327
because they were priced
out of reach

00:06:59.327 --> 00:07:03.819
of the ability of people in
developing countries to pay.

00:07:03.819 --> 00:07:07.421
And third, there were
medicines that existed

00:07:07.421 --> 00:07:09.485
that actually were
developed for use

00:07:09.485 --> 00:07:12.042
to treat tropical diseases,

00:07:12.042 --> 00:07:14.124
but that were no longer produced

00:07:14.124 --> 00:07:16.438
even though the
needs were there.

00:07:16.438 --> 00:07:19.324
The people who needed
the medicines existed,

00:07:19.324 --> 00:07:20.775
but as consumers.

00:07:20.775 --> 00:07:22.571
They did not exist as a market.

00:07:22.571 --> 00:07:24.799
They do no exist because
they don't have enough money

00:07:24.799 --> 00:07:26.882
to pay for the treatment.

00:07:29.692 --> 00:07:31.125
- [Narrator] What's
the difference

00:07:31.125 --> 00:07:33.513
between a generic medicine
and a brand name one?

00:07:33.513 --> 00:07:36.140
Actually they contain the
same active ingredients

00:07:36.140 --> 00:07:38.052
and they're made
in the same way.

00:07:38.052 --> 00:07:40.211
They are identical.

00:07:40.211 --> 00:07:41.627
The brand name ones are patented

00:07:41.627 --> 00:07:44.794
and so they generally
cost a lot more.

00:07:47.862 --> 00:07:51.403
But who regulates
the patenting system?

00:07:51.403 --> 00:07:52.903
Remember one word.

00:07:53.793 --> 00:07:54.793
TRIPS.

00:07:54.795 --> 00:07:55.795
- TR-TR-TRIPS.

00:07:55.800 --> 00:07:57.100
- TRIP, TRIP, TRIP.

00:07:57.101 --> 00:07:58.101
- TRIPS agreement.

00:07:58.110 --> 00:07:59.140
- What it means is...

00:07:59.227 --> 00:08:01.744
- Trade-Related Intellectual
Property.

00:08:01.744 --> 00:08:02.880
Proper, property.

00:08:02.880 --> 00:08:08.047
- Is an agreement covering
intellectual property systems

00:08:08.769 --> 00:08:12.442
and their impact on
international trade.

00:08:12.442 --> 00:08:15.157
It really was the
first major effort

00:08:15.157 --> 00:08:18.620
in the GATT WTO system to create

00:08:18.620 --> 00:08:21.415
a relationship between trade

00:08:21.415 --> 00:08:24.498
and intellectual
property protection.

00:08:27.964 --> 00:08:30.379
- [Narrator] A patent is a
legal title granted by the state

00:08:30.379 --> 00:08:32.192
giving its holder a
temporary monopoly

00:08:32.192 --> 00:08:35.092
on the use of an invention
for a limited area and time.

00:08:35.092 --> 00:08:37.925
(gramophone sounds)

00:08:40.515 --> 00:08:42.049
The patent can cover a product

00:08:42.049 --> 00:08:44.992
or the process used
in making something.

00:08:44.992 --> 00:08:46.694
From the start the
existence of patents

00:08:46.694 --> 00:08:48.797
was justified by the fact
that exclusive rights

00:08:48.797 --> 00:08:52.093
to commercial exploitation
simulates new inventions,

00:08:52.093 --> 00:08:53.925
which when the patent expires

00:08:53.925 --> 00:08:57.445
would pass into the
public domain.

00:08:57.445 --> 00:09:00.480
In recent years, even
genetically modified organisms

00:09:00.480 --> 00:09:01.897
have been patented,

00:09:01.897 --> 00:09:06.048
including plants, animals
and microorganisms

00:09:06.048 --> 00:09:08.131
and the list could go on.

00:09:11.135 --> 00:09:12.973
- There is an important
link between the

00:09:12.973 --> 00:09:14.659
TRIPS agreement and
access to drugs.

00:09:14.659 --> 00:09:17.693
- Because it treated
medicines as any other sector.

00:09:17.693 --> 00:09:20.374
- The TRIPS agreement
obliged all countries

00:09:20.374 --> 00:09:23.486
that the members to they
weren't have any say in

00:09:23.486 --> 00:09:25.486
now around 150 countries

00:09:27.576 --> 00:09:31.939
to adopt the patent protection
for pharmaceuticals.

00:09:31.939 --> 00:09:33.119
- Before the TRIPS agreement,

00:09:33.119 --> 00:09:35.762
countries either don't
grant patents on medicines

00:09:35.762 --> 00:09:37.367
or they grant for
a shorter period,

00:09:37.367 --> 00:09:38.403
five years, 10 years,

00:09:38.403 --> 00:09:40.393
but now you have to
give for 20 years.

00:09:40.393 --> 00:09:43.663
- The patent owner can
charge high prices.

00:09:43.663 --> 00:09:45.439
He may act as a monopoly.

00:09:45.439 --> 00:09:47.396
- So in this 20 year period,

00:09:47.396 --> 00:09:50.566
no other generic medicine
can enter into the market.

00:09:50.566 --> 00:09:52.654
- The patent owner can
charge the price

00:09:52.654 --> 00:09:54.928
that the market may bear

00:09:54.928 --> 00:09:56.630
and this means that many people

00:09:56.630 --> 00:09:59.630
will not be able to
purchase and use

00:10:00.529 --> 00:10:01.540
these patented drugs.

00:10:01.540 --> 00:10:04.095
- This is the problem with the
TRIPS agreement that there...

00:10:04.095 --> 00:10:07.109
It kind of gives the patent
holder a monopoly of the market

00:10:07.109 --> 00:10:09.548
and generic medicines
cannot enter into market

00:10:09.548 --> 00:10:11.512
and because there's
no competition,

00:10:11.512 --> 00:10:13.654
the patent holder is
able to keep prices

00:10:13.654 --> 00:10:15.946
as high as it wants.

00:10:15.946 --> 00:10:17.649
- [Narrator]
TRIPS represents the triumph

00:10:17.649 --> 00:10:19.374
of the particular interest
of the great

00:10:19.374 --> 00:10:22.018
European and American
multinationals

00:10:22.018 --> 00:10:24.548
over the general interests
of billions of people

00:10:24.548 --> 00:10:27.178
in developing countries.

00:10:27.178 --> 00:10:28.609
Trade ministers were not aware

00:10:28.609 --> 00:10:30.589
that in signing
these agreements,

00:10:30.589 --> 00:10:32.789
they were at the same
time condemning

00:10:32.789 --> 00:10:36.566
billions of the world's
poorest citizens to death.

00:10:36.566 --> 00:10:39.614
TRIPS has imposed a regime
of intellectual property

00:10:39.614 --> 00:10:42.771
currently dominant in the
United States and in Europe

00:10:42.771 --> 00:10:44.947
on the entire world.

00:10:44.947 --> 00:10:47.965
Also, the idea that
intellectual property rights

00:10:47.965 --> 00:10:50.095
acted as a stimulus
for innovation

00:10:50.095 --> 00:10:51.665
because they guarantee
higher profits

00:10:51.665 --> 00:10:54.402
to be reinvested in
research and development

00:10:54.402 --> 00:10:56.569
cannot be said to be true.

00:10:59.074 --> 00:11:03.473
- Many of these products are
developed in rich countries

00:11:03.473 --> 00:11:04.722
because these are the countries

00:11:04.722 --> 00:11:05.946
which have the investment

00:11:05.946 --> 00:11:08.249
which have the scientists

00:11:08.249 --> 00:11:11.294
which have the
technological strength

00:11:11.294 --> 00:11:13.294
to produce these things.

00:11:14.662 --> 00:11:16.670
But I think it's important
to point out

00:11:16.670 --> 00:11:18.059
that one of the reasons

00:11:18.059 --> 00:11:22.077
an open international
trading system is important

00:11:22.077 --> 00:11:26.160
is that it does enable
people in poorer countries

00:11:27.055 --> 00:11:29.638
to benefit from these products.

00:11:30.587 --> 00:11:33.176
- [Narrator]
97% of patents worldwide

00:11:33.176 --> 00:11:34.877
are held by people or businesses

00:11:34.877 --> 00:11:37.325
in industrialized countries

00:11:37.325 --> 00:11:41.836
and more than half of the
royalties are paid to the USA.

00:11:41.836 --> 00:11:43.692
Even in developing countries,

00:11:43.692 --> 00:11:46.077
80% of patents are
granted to those

00:11:46.077 --> 00:11:50.419
who are resident in
industrialized countries.

00:11:50.419 --> 00:11:52.461
Even the United States
sometimes finds it hard

00:11:52.461 --> 00:11:53.782
to enforce TRIPS

00:11:53.782 --> 00:11:56.152
like in October 2001
while still reeling

00:11:56.152 --> 00:11:57.975
from the Twin Towers attack,

00:11:57.975 --> 00:11:59.414
there was widespread panic

00:11:59.414 --> 00:12:01.723
about anthrax and a new
bioterrorism attack.

00:12:01.923 --> 00:12:03.843
There was an explosion
in the number of reports

00:12:03.843 --> 00:12:05.184
of anthrax contagion,

00:12:05.184 --> 00:12:06.502
culminating on October the 5th

00:12:06.502 --> 00:12:07.934
with the death of
Robert Stevens,

00:12:07.934 --> 00:12:09.012
a photographer working

00:12:09.012 --> 00:12:11.117
for the American
Media Press Agency.

00:12:11.117 --> 00:12:13.084
There was even a rumor
that President Bush himself

00:12:13.184 --> 00:12:14.502
had been infected

00:12:14.502 --> 00:12:15.582
and the only antibiotic

00:12:15.582 --> 00:12:17.309
known to be effective
against anthrax,

00:12:17.309 --> 00:12:18.309
Cipro,

00:12:18.342 --> 00:12:19.767
produced by Bayer
at the same time,

00:12:19.767 --> 00:12:22.270
still under patent until
the end of 2003,

00:12:22.270 --> 00:12:25.477
became virtually unobtainable.

00:12:25.477 --> 00:12:27.276
The US government
decided to ask Bayer

00:12:27.276 --> 00:12:29.575
to provide an enormous
supply of the drug

00:12:29.575 --> 00:12:33.542
at less than the $5 a pill
that was the retail price.

00:12:38.488 --> 00:12:40.461
Given the German
company's reluctance,

00:12:40.461 --> 00:12:42.126
the US government
announced it's approval

00:12:42.126 --> 00:12:44.208
of two generic pharmaceuticals,

00:12:44.208 --> 00:12:45.938
doxycycline and penicillin

00:12:45.938 --> 00:12:47.794
as a treatment against anthrax.

00:12:47.794 --> 00:12:48.921
Under these pharmaceuticals,

00:12:48.921 --> 00:12:50.933
should be available as generics

00:12:50.933 --> 00:12:52.617
because they could be
produced by a number

00:12:52.617 --> 00:12:53.934
of pharmaceutical companies

00:12:53.934 --> 00:12:57.119
and so be relatively
cheap and easy to obtain.

00:12:57.119 --> 00:12:59.001
(classical music)

00:12:59.001 --> 00:13:01.161
The front page of the
New York Times read

00:13:01.161 --> 00:13:03.163
"American law is very clear.

00:13:03.163 --> 00:13:04.775
"When the United
States government

00:13:04.787 --> 00:13:05.994
needs a patented product,

00:13:05.994 --> 00:13:08.051
"any official authorized
to make purchases

00:13:08.051 --> 00:13:10.904
"can ignore the
patent and license

00:13:10.916 --> 00:13:13.044
someone else to make it."

00:13:13.044 --> 00:13:14.885
The next day Bayer responded

00:13:14.885 --> 00:13:16.522
saying that it was
not at all impressed

00:13:16.522 --> 00:13:18.250
by the US government's actions.

00:13:18.250 --> 00:13:21.083
(classical music)

00:13:22.726 --> 00:13:26.235
Actions violating the
infamous TRIPS,

00:13:26.235 --> 00:13:28.023
but the threat of non-compliance
of TRIPS

00:13:28.023 --> 00:13:30.710
extended into Canada with
more and more offers arriving

00:13:30.710 --> 00:13:34.438
from pharmaceutical
companies producing generics.

00:13:34.438 --> 00:13:36.276
So on October the 25th,

00:13:36.276 --> 00:13:39.224
the US government gained
the upper hand.

00:13:39.224 --> 00:13:40.731
Under the threat
of the generics,

00:13:40.731 --> 00:13:44.234
Bayer agreed to produce
all the pills the US needed

00:13:44.234 --> 00:13:46.817
at the cost of only $0.95 each.

00:13:48.225 --> 00:13:50.745
In the end, however, there
were only three deaths

00:13:50.745 --> 00:13:51.975
from anthrax poisoning

00:13:51.975 --> 00:13:54.523
and a few dozen
cases of contagion.

00:13:54.523 --> 00:13:57.356
(classical music)

00:13:58.223 --> 00:14:00.223
(speaking in Spanish)

00:15:03.386 --> 00:15:05.642
- [Narrator] Parallel imports.

00:15:05.642 --> 00:15:08.156
Thanks to article six
of the TRIPS agreement,

00:15:08.156 --> 00:15:09.480
in the interest of public health

00:15:09.480 --> 00:15:11.455
and for limited periods only,

00:15:11.455 --> 00:15:13.511
it is possible to import
a pharmaceutical drug

00:15:13.511 --> 00:15:17.172
from the company which offers
the best economic conditions

00:15:17.172 --> 00:15:21.339
without asking the patent
holder's permission.

00:15:28.171 --> 00:15:30.171
(speaking in Spanish)

00:15:46.257 --> 00:15:48.641
- [Narrator]
Compulsory licenses.

00:15:48.641 --> 00:15:51.269
Thanks to article 30
of the TRIPS agreement,

00:15:51.269 --> 00:15:53.118
it is possible for a
country experiencing

00:15:53.118 --> 00:15:54.985
a healthcare emergency,

00:15:54.985 --> 00:15:56.494
one country,

00:15:56.494 --> 00:15:58.109
to produce a generic
pharmaceutical

00:15:58.109 --> 00:16:00.315
without paying the
patent rights.

00:16:00.315 --> 00:16:03.315
This license has a
limited duration.

00:16:05.359 --> 00:16:08.879
- They have passed a
compulsory license bill

00:16:08.879 --> 00:16:12.701
that a country can ask
for a compulsory license,

00:16:12.701 --> 00:16:16.868
but they have made the rules
and regulations so difficult

00:16:18.195 --> 00:16:19.811
that it is not practical.

00:16:19.811 --> 00:16:22.311
What they should therefore do,

00:16:23.453 --> 00:16:27.106
that the third world
should have a very simple

00:16:27.106 --> 00:16:30.273
practical compulsory
licensing system.

00:16:31.395 --> 00:16:34.228
(classical music)

00:18:19.091 --> 00:18:20.125
- Developing countries,

00:18:20.125 --> 00:18:22.553
when they wanted to make
use of the flexibilities,

00:18:22.553 --> 00:18:24.224
there was a lot of
pressure on them

00:18:24.224 --> 00:18:26.360
from the pharmaceutical
companies as well as

00:18:26.360 --> 00:18:28.772
some of the
industrialized countries

00:18:28.772 --> 00:18:31.102
not to make use of
this flexibility.

00:18:31.102 --> 00:18:33.289
This was a case of
say South Africa

00:18:33.289 --> 00:18:34.594
when they wanted to make use,

00:18:34.594 --> 00:18:36.503
change their loss
and the flexibilities

00:18:36.503 --> 00:18:38.267
that any pharmaceutical
companies

00:18:38.267 --> 00:18:40.570
took South African
government to court about it.

00:18:40.570 --> 00:18:42.536
- Hundreds of
protesters affiliated

00:18:42.548 --> 00:18:43.922
to the AIDS lobby group,

00:18:43.922 --> 00:18:47.781
the Treatment Action Campaign
and Labor Federation Cassato,

00:18:47.781 --> 00:18:50.954
are marching through
the streets of Pretoria.

00:18:50.954 --> 00:18:52.954
The Pharmaceutical
Manufacturers Association

00:18:52.954 --> 00:18:55.262
is suing the
South African government

00:18:55.262 --> 00:18:57.246
for a law that
enables the country

00:18:57.246 --> 00:18:59.112
to purchase generic drugs

00:18:59.112 --> 00:19:01.916
rather than their more
expensive equivalents.

00:19:01.916 --> 00:19:04.863
- We are ready if necessary

00:19:04.863 --> 00:19:07.259
to take all the
measures necessary

00:19:07.259 --> 00:19:10.156
to get treatment to
people with HIV and AIDS.

00:19:10.156 --> 00:19:13.864
- This case is really
about what comes first,

00:19:13.864 --> 00:19:16.576
commercial interest of
the multinationals

00:19:16.576 --> 00:19:18.726
or the right to life of people.

00:19:18.726 --> 00:19:19.726
- Good afternoon.

00:19:19.730 --> 00:19:20.930
Welcome to One O'Clock Live.

00:19:20.931 --> 00:19:22.075
I'm Sally Burdette.

00:19:22.075 --> 00:19:23.298
News from around the country,

00:19:23.298 --> 00:19:25.114
around the world at lunch time.

00:19:25.114 --> 00:19:26.114
In the headlines,

00:19:26.120 --> 00:19:28.375
drug companies drop their
lawsuit against the government.

00:19:28.402 --> 00:19:30.883
- This is a win-win
situation for the government

00:19:30.883 --> 00:19:33.078
and the Treatment
Action Campaign.

00:19:33.078 --> 00:19:35.321
Not only has the case
been withdrawn,

00:19:35.321 --> 00:19:38.205
but the Pharmaceutical
Manufacturers Association

00:19:38.205 --> 00:19:40.547
has agreed to pay legal costs.

00:19:40.547 --> 00:19:42.394
- They believe a major victory

00:19:42.394 --> 00:19:44.358
that prevented a
pharmaceutical company

00:19:44.358 --> 00:19:45.502
appears withdrawn.

00:19:45.502 --> 00:19:48.519
- We're going to need many
more countries making use

00:19:48.519 --> 00:19:50.226
of the Doha Declaration

00:19:50.226 --> 00:19:52.773
and particularly
producing countries

00:19:52.773 --> 00:19:56.726
because if the larger producing
countries such as India,

00:19:56.726 --> 00:19:59.927
do not allow their
companies to produce

00:19:59.927 --> 00:20:03.008
generic versions of
newer medicines,

00:20:03.008 --> 00:20:04.666
there is at the end of the day,

00:20:04.666 --> 00:20:08.948
there aren't going to be any
sources left to import from.

00:20:08.948 --> 00:20:12.503
(background chatter)

00:20:12.503 --> 00:20:15.366
- [Narrator] In 2005 India
had to bring its patent laws

00:20:15.366 --> 00:20:17.731
into line with TRIPS.

00:20:17.731 --> 00:20:21.419
Patents on pharmaceutical
products were reintroduced.

00:20:21.419 --> 00:20:25.067
The only possible loophole
is article 3D of the new law,

00:20:25.067 --> 00:20:27.792
which states that a patent
cannot be granted for any drug

00:20:27.792 --> 00:20:28.953
which does not represent

00:20:28.953 --> 00:20:32.462
a substantial
pharmaceutical innovation.

00:20:32.462 --> 00:20:35.304
That's why Novartis
anticancer drug Glivec

00:20:35.304 --> 00:20:37.519
did not qualify for a patent

00:20:37.519 --> 00:20:39.756
and why Novartis has taken
the Indian government

00:20:39.756 --> 00:20:41.506
and its law to court.

00:20:48.555 --> 00:20:51.805
- They say that they
want a declaration

00:20:53.321 --> 00:20:56.357
the treaty is unconstitutional.

00:20:56.357 --> 00:20:57.798
That is the prayer.

00:20:57.798 --> 00:20:58.814
They ever had it,

00:20:58.814 --> 00:21:01.184
also another prayer
which is not here,

00:21:01.184 --> 00:21:04.635
the treaty is in
violation of TRIPS.

00:21:04.635 --> 00:21:06.709
So you want a copy of that?

00:21:06.709 --> 00:21:08.381
It's on argument

00:21:08.381 --> 00:21:11.187
that under the TRIPS agreement,

00:21:11.187 --> 00:21:15.571
a private individual cannot
argue in a domestic court

00:21:15.571 --> 00:21:20.490
that any law of any country
is not TRIPS compliant.

00:21:20.490 --> 00:21:23.007
That is only for the
government to do

00:21:23.007 --> 00:21:26.477
and that to in the
W2 dispute panel.

00:21:26.477 --> 00:21:27.597
So a garden door,

00:21:27.597 --> 00:21:29.220
they cannot make a declaration.

00:21:29.220 --> 00:21:31.675
That is what we are waiting
on the court to decide.

00:21:31.675 --> 00:21:33.870
They need not have
challenge treaty at all,

00:21:33.870 --> 00:21:35.723
but since they've
challenged treaty,

00:21:35.723 --> 00:21:36.729
if they succeed,

00:21:36.729 --> 00:21:39.383
it'll impact all the drugs.

00:21:39.383 --> 00:21:42.089
Whether they're cancer
drugs or anticancer drugs

00:21:42.089 --> 00:21:44.686
or antiretroviral
or TB, malaria.

00:21:44.686 --> 00:21:46.693
If we succeed ourselves,

00:21:46.693 --> 00:21:50.050
then it also impacts
favorably on all the drugs

00:21:50.050 --> 00:21:53.217
so treaty challenge impacts
on all drugs.

00:21:59.135 --> 00:22:01.968
(classical music)

00:22:09.475 --> 00:22:11.150
- [Narrator]
India is the main producer

00:22:11.150 --> 00:22:13.773
and exporter of high
quality generic drugs.

00:22:13.773 --> 00:22:15.961
Companies such as
Robaxin and Cipla

00:22:15.961 --> 00:22:17.491
sell their medicines
to many nations

00:22:17.491 --> 00:22:19.044
in the southern hemisphere

00:22:19.044 --> 00:22:22.483
and to organizations including
Medecins Sans Frontieres

00:22:22.483 --> 00:22:25.857
who buy 80% of their
medicines from India.

00:22:25.857 --> 00:22:29.182
These are companies with
very high equality standards.

00:22:29.182 --> 00:22:32.183
Cipla was founded in
the 1930s to allow India

00:22:32.183 --> 00:22:33.637
to break away from
its dependence

00:22:33.637 --> 00:22:36.457
in the British pharmaceuticals
industry.

00:22:36.457 --> 00:22:40.624
Gandhi himself was enthusiastic
about his foundation.

00:22:44.131 --> 00:22:45.204
- No, no, no.

00:22:45.204 --> 00:22:47.133
I like intellectual property.

00:22:47.133 --> 00:22:50.800
I certainly believe
that if somebody invents

00:22:52.242 --> 00:22:53.903
a new drug or something,

00:22:53.903 --> 00:22:56.804
he should be suitably rewarded.

00:22:56.804 --> 00:22:58.728
There is no question about that.

00:22:58.728 --> 00:23:00.658
I've never been against patents.

00:23:00.658 --> 00:23:01.658
Please.

00:23:01.730 --> 00:23:04.504
I have been against monopoly.

00:23:04.504 --> 00:23:06.549
That in the third world,

00:23:06.549 --> 00:23:10.716
any country like India with
1.1 billion people today,

00:23:13.117 --> 00:23:16.117
likely to go to 1.5
billion by 2020.

00:23:18.906 --> 00:23:21.239
We cannot afford a monopoly.

00:23:22.117 --> 00:23:24.950
(classical music)

00:23:42.139 --> 00:23:43.339
- [Narrator] The golden age

00:23:43.372 --> 00:23:46.529
of the India pharmaceutical
industry began in 1972,

00:23:46.529 --> 00:23:48.124
when Indira Gandhi
abolished patents

00:23:48.124 --> 00:23:50.199
on pharmaceutical products
as a means of addressing

00:23:50.199 --> 00:23:52.116
internal health crises.

00:23:53.010 --> 00:23:57.177
This considerably boosted
the production of generics.

00:23:58.745 --> 00:24:03.812
- In 1984, the Italian local
pharmaceutical industry,

00:24:05.544 --> 00:24:07.780
the indigenous Italian industry,

00:24:07.780 --> 00:24:09.813
was on top of the world.

00:24:09.813 --> 00:24:11.527
You had Carlo Erba,

00:24:11.527 --> 00:24:13.616
you had Farmitalia.

00:24:13.616 --> 00:24:14.860
You had all the large...

00:24:14.860 --> 00:24:15.860
Lipitea.

00:24:15.952 --> 00:24:18.457
All the large Italian companies.

00:24:18.457 --> 00:24:21.694
They were manufacturing
in Italy and exporting.

00:24:21.694 --> 00:24:25.027
Then in 1984, like what
India did in 1995,

00:24:27.032 --> 00:24:31.386
they reintroduced what is
called product patterns

00:24:31.386 --> 00:24:33.066
and the minute they reintroduced

00:24:33.066 --> 00:24:36.674
the Italian pharma
industry went down.

00:24:36.674 --> 00:24:40.052
The same is likely
to happen to India.

00:24:40.052 --> 00:24:43.488
If you look at the
disease pattern in India,

00:24:43.488 --> 00:24:45.821
110 million mental patients,

00:24:46.838 --> 00:24:49.430
18 million heart patients,

00:24:49.430 --> 00:24:51.538
60 million diabetics,

00:24:51.538 --> 00:24:54.153
60 million asthmatics.

00:24:54.153 --> 00:24:57.279
One in three Indians
is got latent TB.

00:24:57.279 --> 00:25:00.495
50 million hepatitis B cases.

00:25:00.495 --> 00:25:04.162
By 2015 we will have
35 million HIV positive

00:25:07.012 --> 00:25:09.179
so these figures cannot...

00:25:10.760 --> 00:25:13.927
India simply cannot
afford a monopoly.

00:26:15.915 --> 00:26:19.255
But what the government
has essentially done

00:26:19.255 --> 00:26:23.338
has neglected the poor
man on the street in India

00:26:24.827 --> 00:26:28.994
and they have virtually
committed selective genocide

00:26:30.528 --> 00:26:34.595
that by 2015 hardly any
Indians will be able

00:26:35.481 --> 00:26:39.998
to afford lifesaving
and essential drugs.

00:27:04.645 --> 00:27:07.728
(background chatter)

00:27:38.918 --> 00:27:40.985
(speaking in local language)

00:29:17.895 --> 00:29:20.728
(classical music)

00:29:27.047 --> 00:29:29.723
- [Narrator] The impact
of HIV/AIDS in Africa

00:29:29.723 --> 00:29:30.973
is devastating.

00:29:32.202 --> 00:29:34.633
Not only does it cause
millions of deaths,

00:29:34.633 --> 00:29:36.794
but it is dealt a harsh
blow to the already

00:29:36.794 --> 00:29:39.518
fragile economies and
has caused changes

00:29:39.518 --> 00:29:42.377
in patterns of behavior
and lifestyle.

00:29:42.377 --> 00:29:44.019
(classical music)

00:29:44.019 --> 00:29:47.102
(background chatter)

00:30:22.437 --> 00:30:25.270
(classical music)

00:30:47.258 --> 00:30:49.325
(speaking in local language)

00:32:46.464 --> 00:32:50.214
(speaking in local language)

00:33:02.163 --> 00:33:04.538
- AIDS is a neglected disease.

00:33:04.538 --> 00:33:07.822
Even though there's a lot of
research going on in AIDS,

00:33:07.822 --> 00:33:09.970
all the research and
development efforts

00:33:09.970 --> 00:33:13.632
are geared towards finding
the next generation

00:33:13.632 --> 00:33:16.419
of medicine to treat the people

00:33:16.419 --> 00:33:19.455
in Europe and in North America

00:33:19.455 --> 00:33:22.924
that need a new generation
of antiretroviral treatment

00:33:22.924 --> 00:33:25.375
to deal with their resistance,

00:33:25.375 --> 00:33:28.356
but the kind of research
we need today on AIDS

00:33:28.356 --> 00:33:32.424
is tools easier to use
on the large scale

00:33:32.424 --> 00:33:34.077
in resource poor settings.

00:33:34.077 --> 00:33:36.668
We need medicines to
treat children with AIDS.

00:33:36.668 --> 00:33:38.433
Children with AIDS
almost do not exist

00:33:38.433 --> 00:33:40.116
in Europe and North America

00:33:40.116 --> 00:33:42.740
so the development of these
products do not take place.

00:33:42.740 --> 00:33:45.129
- [Narrator] The profit made
in the pharmacological sector

00:33:45.129 --> 00:33:49.396
in the 1990s was equivalent
to 25% of the total turnover,

00:33:49.595 --> 00:33:53.190
well over that made by any
other consumer goods sector.

00:33:53.190 --> 00:33:55.665
These are colossal
profit margins.

00:33:55.665 --> 00:33:56.708
To give you an idea,

00:33:56.708 --> 00:33:59.070
the average profit in other
sectors in the same period

00:33:59.070 --> 00:34:01.735
was 3.3% of turnover

00:34:01.735 --> 00:34:03.746
so you would expect there
to be a huge investment

00:34:03.746 --> 00:34:05.722
in research and development.

00:34:05.722 --> 00:34:09.497
Yet Big Pharma only
invested about 11% to 14%

00:34:09.497 --> 00:34:11.097
in research and development

00:34:11.097 --> 00:34:13.806
while their expenditure
in marketing and admin

00:34:13.806 --> 00:34:17.082
amounted to 36% of turnover.

00:34:17.082 --> 00:34:19.709
- It is true that
there are prices

00:34:19.709 --> 00:34:23.640
which are high so to
speak at the beginning

00:34:23.640 --> 00:34:26.323
compared to the end
price of the drug,

00:34:26.323 --> 00:34:28.261
but marketing also
is part of this

00:34:28.261 --> 00:34:32.049
because the company
has eight to 10 years

00:34:32.049 --> 00:34:34.645
of the exclusive right
under the patent

00:34:34.645 --> 00:34:38.812
and that company is competing
with other patented drugs.

00:34:44.502 --> 00:34:48.508
The research company has
to recoup to catch back

00:34:48.508 --> 00:34:50.644
the cost of research
and development

00:34:50.644 --> 00:34:52.923
over an eight year period

00:34:52.923 --> 00:34:55.340
or frequently it can be less.

00:34:56.698 --> 00:34:58.557
- [Narrator] In
the 1970s, roughly

00:34:58.569 --> 00:34:59.959
17 new chemical compounds

00:34:59.959 --> 00:35:02.418
were recorded each year.

00:35:02.418 --> 00:35:04.757
Since then there's been
a constant reduction

00:35:04.757 --> 00:35:07.375
in genuine pharmaceutical
innovations,

00:35:07.375 --> 00:35:11.891
arriving at the mere 23
substances approved in 2004,

00:35:11.891 --> 00:35:14.767
of which only four can
be considered significant

00:35:14.767 --> 00:35:16.517
therapeutic advances.

00:35:19.228 --> 00:35:22.611
- The expense comes essentially

00:35:23.599 --> 00:35:27.782
in what is called evergreening.

00:35:29.228 --> 00:35:32.040
That means how if I have
a good product,

00:35:32.040 --> 00:35:35.344
how do I extend the patent life.

00:35:35.344 --> 00:35:36.384
But tell me something.

00:35:36.384 --> 00:35:37.747
If you have a drug,

00:35:37.747 --> 00:35:39.872
say an antidepressant drug,

00:35:39.872 --> 00:35:42.972
how many patents should
a drug really have?

00:35:42.972 --> 00:35:45.336
Two, three, four, five?

00:35:45.336 --> 00:35:47.295
Now there are drugs today,

00:35:47.295 --> 00:35:49.812
controlled by the
multinationals,

00:35:49.812 --> 00:35:51.753
where there are 240 patents

00:35:51.753 --> 00:35:53.825
on the same drug.

00:35:53.825 --> 00:35:56.499
Different crystalline forms
of the drug,

00:35:56.499 --> 00:35:59.013
different SORS, different ESTAS.

00:35:59.013 --> 00:36:02.044
Then metabolites, probe drugs,

00:36:02.044 --> 00:36:04.543
new drug delivery systems.

00:36:04.543 --> 00:36:06.997
So the whole thing
is camouflaged

00:36:06.997 --> 00:36:09.997
so that they can
extend patent life.

00:36:11.727 --> 00:36:13.794
(speaking in Spanish)
(not subtitled)

00:36:27.702 --> 00:36:30.737
- Many of the old drugs
were developed

00:36:30.737 --> 00:36:32.178
for different reasons.

00:36:32.178 --> 00:36:33.211
For example,

00:36:33.211 --> 00:36:36.861
for military reasons or
even as a final stage

00:36:38.768 --> 00:36:41.520
of colonialism when
European powers

00:36:41.520 --> 00:36:43.728
were interested in malaria

00:36:43.728 --> 00:36:45.836
because they had many
of their own citizens

00:36:45.836 --> 00:36:47.524
in malarious areas.

00:36:47.524 --> 00:36:50.191
As soon as those motivations go,

00:36:51.597 --> 00:36:53.890
then there is no
motivation to develop,

00:36:53.890 --> 00:36:58.057
no commercial motivation
to develop malaria drugs.

00:37:00.390 --> 00:37:02.457
(voice-over in Italian)

00:38:31.162 --> 00:38:34.712
- If malaria was a disease
in Europe or the US,

00:38:34.712 --> 00:38:37.129
we would cure it very easily.

00:38:38.069 --> 00:38:40.249
The real problem is
that most people

00:38:40.249 --> 00:38:42.832
who have malaria are very poor.

00:38:43.785 --> 00:38:46.202
They cannot afford good drugs

00:38:47.254 --> 00:38:49.965
so they have relied
mainly on old drugs,

00:38:49.965 --> 00:38:52.465
which have resistance to them.

00:38:53.343 --> 00:38:57.010
(speaking in local language)
(not subtitled)

00:39:05.728 --> 00:39:08.628
- You have to prevent
people from getting malaria.

00:39:08.628 --> 00:39:11.341
That includes things
like bed nets.

00:39:11.341 --> 00:39:14.630
It includes things like
controlling the mosquitoes,

00:39:14.630 --> 00:39:15.630
but even so,

00:39:15.722 --> 00:39:18.275
there are hundreds
of millions of people

00:39:18.275 --> 00:39:22.442
who develop malaria and
those people need medicines.

00:39:23.527 --> 00:39:26.610
(indistinct chatter)

00:39:30.110 --> 00:39:33.194
- [Narrator] In March 2007,
the nonprofit organization

00:39:33.194 --> 00:39:36.620
Drugs for Neglected
Diseases, an MSF initiative,

00:39:36.620 --> 00:39:38.082
and Sanofi-Aventis

00:39:38.082 --> 00:39:39.659
developed an anti malaria drug

00:39:39.659 --> 00:39:41.638
that would only cost $1 a pill

00:39:41.638 --> 00:39:43.388
and most importantly,

00:39:43.388 --> 00:39:45.419
will be patent free.

00:39:45.419 --> 00:39:48.284
Anyone will be able to
produce it and improve it.

00:39:48.284 --> 00:39:50.420
Its name is ASAQ.

00:39:50.420 --> 00:39:52.244
Who knows if this new
drug will really help

00:39:52.244 --> 00:39:53.827
those most in need.

00:39:56.619 --> 00:40:00.131
- You can have a free
drug that's given away.

00:40:00.131 --> 00:40:01.231
For example,

00:40:01.364 --> 00:40:04.631
the WHO knows that the medicines

00:40:04.761 --> 00:40:07.777
that were donated
this year by major...

00:40:07.777 --> 00:40:10.546
one of our member companies
for sleeping sickness

00:40:10.546 --> 00:40:13.697
is not getting to many
patients in Africa.

00:40:13.697 --> 00:40:14.943
Not because of the price,

00:40:14.943 --> 00:40:17.657
because the drugs
were given away.

00:40:17.657 --> 00:40:18.927
They're not getting to patients

00:40:18.927 --> 00:40:21.394
because there's no
structure to deliver

00:40:21.394 --> 00:40:22.394
these medicines.

00:40:22.484 --> 00:40:25.467
(indistinct chatter)

00:40:37.890 --> 00:40:40.390
(speaking in Spanish)

00:41:10.382 --> 00:41:12.448
(speaking in local language)

00:42:07.306 --> 00:42:10.247
- What we are proposing
is that governments

00:42:10.247 --> 00:42:15.247
need to clearly spell
what their priorities are.

00:42:15.325 --> 00:42:16.525
For example,

00:42:16.558 --> 00:42:18.628
if they came to Kenya
and someone wanted

00:42:18.628 --> 00:42:20.434
to do business in Kenya,

00:42:20.434 --> 00:42:22.318
we will clearly indicate to them

00:42:22.318 --> 00:42:24.391
that the priority diseases
in this country

00:42:24.391 --> 00:42:26.255
are one, two, three, four, five

00:42:26.255 --> 00:42:28.582
and if someone wanted
to do business,

00:42:28.582 --> 00:42:31.858
they would need to show
that they're covering

00:42:31.858 --> 00:42:35.377
the areas of priority
as they do business

00:42:35.377 --> 00:42:37.108
in the other areas of health.

00:42:37.108 --> 00:42:39.941
(classical music)

00:42:43.058 --> 00:42:44.993
- [Narrator] South Africa
has the highest number

00:42:44.993 --> 00:42:47.481
of HIV positive
people in the world,

00:42:47.481 --> 00:42:49.781
over 6.5 million people.

00:42:50.606 --> 00:42:53.439
(classical music)

00:42:55.471 --> 00:42:58.220
A portion of the anti-HIV
medication arrives

00:42:58.220 --> 00:43:01.051
thanks to a sizable
contribution from the States

00:43:01.051 --> 00:43:03.141
and international organizations,

00:43:03.141 --> 00:43:06.974
as well as the large
humanitarian foundations.

00:43:10.312 --> 00:43:13.673
- It's like the Gates
Foundation today in AIDS.

00:43:13.673 --> 00:43:14.822
They will not treat,

00:43:14.822 --> 00:43:17.628
but they say we will
spend our money

00:43:17.628 --> 00:43:20.397
to develop an AIDS vaccine.

00:43:20.397 --> 00:43:23.256
So who develops the
AIDS vaccine for Gates?

00:43:23.256 --> 00:43:24.589
Merck in America.

00:43:25.866 --> 00:43:28.829
Indians are being used as
guinea pigs for the trials.

00:43:28.829 --> 00:43:30.482
Fine.

00:43:30.482 --> 00:43:31.482
Good.

00:43:31.515 --> 00:43:32.970
I'm not saying no,

00:43:32.970 --> 00:43:37.144
but I asked the Gates
Foundation a question.

00:43:37.144 --> 00:43:40.495
That suppose a
vaccine is developed

00:43:40.495 --> 00:43:41.600
and God willing,

00:43:41.600 --> 00:43:43.600
there will be a vaccine.

00:43:45.960 --> 00:43:48.444
With your money it
is being developed.

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Will India get the know-how
to produce that vaccine free?

00:43:53.497 --> 00:43:54.497
They said no.

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This is the property of Merck.

00:43:57.564 --> 00:44:01.481
So then if Merck charges
$400 per vaccine shot,

00:44:03.863 --> 00:44:06.431
who's going to pay for it?

00:44:06.431 --> 00:44:08.744
I can't copy it anymore.

00:44:08.744 --> 00:44:10.327
Under the new laws.

00:44:11.409 --> 00:44:15.576
So I'm a great believer
that public-funded research

00:44:17.023 --> 00:44:19.464
should be free for the public.

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You should not be
allowed to patent it.

00:44:21.960 --> 00:44:25.058
- [Narrator] In 2004, the
Parliamentary Inquiry Commission

00:44:25.058 --> 00:44:26.640
set up in the UK to control

00:44:26.640 --> 00:44:28.712
the local
pharmaceutical industry

00:44:28.712 --> 00:44:30.622
declared the health minister

00:44:30.622 --> 00:44:32.706
has taken it for granted
for too long

00:44:32.706 --> 00:44:34.356
and has been too optimistic

00:44:34.356 --> 00:44:35.956
that the interests
of public health

00:44:35.956 --> 00:44:39.408
and those of the pharmaceuticals
industry should coincide.

00:44:39.408 --> 00:44:40.719
The result is that the industry

00:44:40.719 --> 00:44:43.827
has been given the green
light for far too long.

00:44:43.827 --> 00:44:45.027
The influence of the industry

00:44:45.108 --> 00:44:47.293
can be seen at all levels
of health assistance.

00:44:47.293 --> 00:44:48.963
From the initial discovery
and development

00:44:48.963 --> 00:44:50.616
of drugs with clinical trials

00:44:50.616 --> 00:44:53.009
to their promotion with
doctor and patient groups,

00:44:53.009 --> 00:44:55.034
up to their prescription
and the setting down

00:44:55.034 --> 00:44:56.791
of clinical guidelines.

00:44:56.791 --> 00:44:58.185
There has been a
definite tendency

00:44:58.185 --> 00:45:00.970
to classify more and more
individuals as abnormal

00:45:00.970 --> 00:45:04.706
or in need of
pharmacological treatment.

00:45:04.706 --> 00:45:07.539
(classical music)

00:45:09.432 --> 00:45:10.817
So the pharmaceutical houses

00:45:10.817 --> 00:45:12.449
with the consensus
of governments

00:45:12.449 --> 00:45:15.556
are altering our
concept to illness.

00:45:15.556 --> 00:45:19.131
(classical music)

00:45:19.131 --> 00:45:20.400
A case in point is that

00:45:20.400 --> 00:45:23.321
of high blood pressure
or hypertension.

00:45:23.321 --> 00:45:26.828
Until 2003 the starting
point of hypertension

00:45:26.828 --> 00:45:28.399
was deemed to be
when blood pressure

00:45:28.399 --> 00:45:30.876
had a maximum of over 140

00:45:30.876 --> 00:45:32.959
and a minimum of over 90.

00:45:34.020 --> 00:45:37.998
After 2003, an expert panel
decided on the existence

00:45:37.998 --> 00:45:39.533
of pre-hypertension,

00:45:39.533 --> 00:45:42.066
which ranges from 120 stroke 80

00:45:42.066 --> 00:45:43.483
to 140 stroke 90.

00:45:44.521 --> 00:45:45.961
And so many people found

00:45:45.961 --> 00:45:48.999
that they had a medical
problem overnight.

00:45:48.999 --> 00:45:51.832
(classical music)

00:46:00.289 --> 00:46:02.117
- [Narrator]
Or an even more serious case

00:46:02.117 --> 00:46:05.214
is that of the so-called
attention deficit disorder

00:46:05.214 --> 00:46:06.745
or hyperactivity,

00:46:06.745 --> 00:46:09.533
particularly common
amongst children.

00:46:09.533 --> 00:46:11.291
And so during the 1990s,

00:46:11.291 --> 00:46:14.351
since it was decided that
this was indeed a disorder

00:46:14.351 --> 00:46:15.967
and not a normal condition,

00:46:15.967 --> 00:46:18.827
the number of children labeled
as being affected by ADD

00:46:18.827 --> 00:46:22.652
has increased sevenfold
to the extent that today

00:46:22.652 --> 00:46:25.894
15% of school age children
in the United States

00:46:25.894 --> 00:46:28.530
take amphetamines regularly

00:46:28.530 --> 00:46:31.524
and the same thing is
happening in other countries.

00:46:31.524 --> 00:46:33.389
So if during the next few months

00:46:33.389 --> 00:46:36.382
your children start
getting too exuberant,

00:46:36.382 --> 00:46:38.484
take heart in knowing you
can soon calm them down

00:46:38.484 --> 00:46:41.101
with a healthy dose of Ritalin.

00:46:41.101 --> 00:46:43.278
- Over the last few
decades we've seen

00:46:43.278 --> 00:46:45.885
a kind of privatization
of healthcare

00:46:45.885 --> 00:46:48.209
and a privatization of research,

00:46:48.209 --> 00:46:49.513
privatization of health research

00:46:49.513 --> 00:46:52.297
and a privatization of the
development of new products,

00:46:52.297 --> 00:46:54.637
which of course has
led to a system

00:46:54.637 --> 00:46:56.005
that will serve the market,

00:46:56.005 --> 00:46:57.310
but if the market doesn't exist,

00:46:57.310 --> 00:46:58.865
you're not served.

00:46:58.865 --> 00:47:02.081
So that I feel is
a huge barrier.

00:47:02.081 --> 00:47:04.787
It's a little difficult to
ask pharmaceutical companies

00:47:04.787 --> 00:47:07.015
that have been established
to make money

00:47:07.015 --> 00:47:09.427
and satisfy their shareholders

00:47:09.427 --> 00:47:10.850
to do things that
will ultimately

00:47:10.850 --> 00:47:12.999
not bring a lot of money.

00:47:12.999 --> 00:47:15.056
You need the
governments involved.

00:47:15.056 --> 00:47:17.092
You need governments
to regulate things.

00:47:17.092 --> 00:47:20.201
You need different
funding sources

00:47:20.201 --> 00:47:23.807
and you need the
health sector involved

00:47:23.807 --> 00:47:25.175
in setting the priorities.

00:47:25.175 --> 00:47:28.008
(classical music)

00:47:34.664 --> 00:47:36.851
- [Narrator] Pharmaceutical
companies tend to produce

00:47:36.851 --> 00:47:38.857
a massive marketing operation,

00:47:38.857 --> 00:47:41.028
dressed up as science
financing research,

00:47:41.028 --> 00:47:42.181
sponsoring conferences,

00:47:42.181 --> 00:47:43.981
studies, publications

00:47:44.041 --> 00:47:46.327
supporting associations

00:47:46.327 --> 00:47:47.990
in such a way that many medics

00:47:47.990 --> 00:47:50.804
feel that they shouldn't bite
the hand that feeds them.

00:47:50.804 --> 00:47:53.637
(classical music)

00:47:59.088 --> 00:48:01.918
In the west spending on
medicines is increasing

00:48:01.918 --> 00:48:04.623
by about 7% a year,

00:48:04.623 --> 00:48:08.290
while the GNP is only
increasing by 2%.

00:48:11.023 --> 00:48:14.012
How much longer will the health
systems of wealthy countries

00:48:14.012 --> 00:48:16.916
be able to withstand the
increasing cost of medicines

00:48:16.916 --> 00:48:21.523
and guarantee their citizens
free access to them?

00:48:21.523 --> 00:48:24.160
How much longer will the
problem of access to medicine

00:48:24.160 --> 00:48:26.266
be confined to poor nations?

00:48:26.266 --> 00:48:29.099
(classical music)

00:48:32.516 --> 00:48:35.599
(African drum music)

00:49:20.426 --> 00:49:24.093
(speaking in local language)

00:49:25.032 --> 00:49:28.115
(African drum music)

00:50:25.249 --> 00:50:28.249
(ambient music)

00:50:59.957 --> 00:51:02.957
(chanting)